There are fewer health issues in sport that has received as much media focus than concussions.  Whether it is in Rugby League, AFL, American Football or Hockey, there is a hot discussion about the injury itself, return-to-play criteria and long-term issues that may arise. Concussions are not restricted to just professional athletes, but can occur to amateurs, weekend warriors or even children. In fact, several studies actually demonstrate that the number of reported cases of concussions among children is on the rise.

What is a concussion?

Concussion can be defined as a complex pathophysiological process affecting the brain, induced by traumatic biomechanical forces. It can be caused either by a direct blow to the head, face, neck or elsewhere on the body with an impulsive force transmitted to the head.

How to assess an athlete for concussion

The Sport Concussion Assessment Tool 2 (SCAT2) tool represents a standardized method of evaluating, assessing and managing injured athletes for concussion and can be used in athletes aged from 10 years and older. The SCAT2 is designed for the use of medical and health professionals to evaluate symptoms, cognitive and physical signs.

The suspected diagnosis for concussions can include one or more of the following clinical domains:

  1. Symptoms – somatic (eg, headache), cognitive (eg, feeling like in a fog) and/or emotional symptoms.
  2. Physical signs (eg, loss of consciousness, amnesia).
  3. Behavioural changes (eg, irritability).
  4. Cognitive impairment (eg, slowed 
reaction times).
  5. Sleep disturbance (eg, drowsiness).

If any one or more of these components is present, a concussion should be suspected and the appropriate management strategy instituted.

What is the management for concussion

The foundation for best management for a concussion is physical and cognitive rest until symptoms have returned to normal. Majority of concussions will recover spontaneously from a few days to a couple of weeks. As mentioned earlier, physical and cognitive rest is required. So this even includes activities that require concentration and attentiveness (eg, school work, playing video games, texting, watching tv, reading, etc). Otherwise these may potentially worsen the symptoms and even delay the recovery.

Return to play criteria

The Chiropractors role

Chiropractors are an important member for any team for the management of concussion injuries. It’s imperative to have a fundamental knowledge of anatomy, pathophysiology and neurology, accompanied by sound clinical judgment to help diagnose and manage a concussion injury, all of which Chiropractors should have. A Chiropractor should be able to make a quick diagnosis, followed by appropriate treatment. Any delay or confusion in the diagnosis can cause further harm to the athlete.


Johnson, C.D., et al. 

Chiropractic and concussion in sport: a narrative review of the literature.

Journal of Chiropractic Medicine 2013 (12):216-229.Shane, E.R., et al. 

Sports Chiropractic management of concussions using the Sports Concussion Assessment Tool 2 symptom scoring, serial examinations, and graded return to play protocol: a retrospective case series.

 Journal of  Chiropractic Medicine 2013 (12): 252-9.McCrory P, Meeuwisse W, Johnston K, Dvorak J, Aubry M, Molloy M, Cantu R. Consensus Statement on Concussion in Sport: the 3rd International Conference on Concussion in Sport held in Zurich, November 2008.
Br. J. Sports Med. 2009;43;i76-i84

Image Credit: Keith Allison

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